VEGF (in situ macular edema & uveitis

眼内和全身血管生成因子血管内皮生长因子（VEGF）水平升高与眼部新血管生长有关，如糖尿病视网膜病变。最近使用免疫病理学技术的研究表明，VEGF在实验诱导的葡萄膜炎和葡萄膜炎眼睛中都是上调的，没有新血管形成的证据。这项初步研究评估了伴有和不伴有囊样黄斑水肿的葡萄膜患者血液中VEGF的水平。在接受眼科手术的患者的眼液中也测定了这一水平。我们测量了20例葡萄膜炎患者（9例有CME， 11例无CME）房水中的VEGF浓度，以及40例葡萄膜炎患者（20例有CME， 20例无CME）和20名健康志愿者血浆中的VEGF浓度。结果：伴有和不伴有CME的葡萄膜炎患者房水中VEGF的平均浓度分别为152.3和109.5 pg/mL, p=0.048。伴有和不伴有CME的葡萄膜炎患者以及健康志愿者的平均血浆VEGF浓度分别为32.2、29.6和55.0 pg/mL。葡萄膜炎患者血浆VEGF水平低于健康志愿者，p=0.002。结论：葡萄膜炎伴CME患者房水中VEGF浓度升高。全身免疫抑制的葡萄膜炎患者血浆VEGF浓度降低。VEGF拮抗剂可能用于治疗葡萄膜炎相关CME。

Inreased intraocular and systemic levels of the angiogenic factor vascular endothelial growth factor (VEGF) is associated with new vessel growth in the eye, such as diabetic retinopathy. Recent work using immunopathologic techniques have shown that VEGF is upregulated in both experimentally induced uveitis and in uveitis eyes as well, with no evidence of neovascularization. This pilot study evaluated the level of VEGF in the blood of uveitic patients with and without cystoid macular edema. This level was determined also in the ocular fluid of those patietns undergoing ocular surgery.We measured the VEGF concentration in the aqueous humor of 20 uveitis patients (9 with and 11 without CME), and in the plasma of 40 uveitis patients (20 with and 20 without CME) and 20 healthy volunteers. Results: Mean aqueous humor VEGF concentrations for uveitis patients with and without CME were 152.3 and 109.5 pg/mL, p=0.048. Mean plasma VEGF concentrations in uveitis patients with and without CME and in healthy volunteers were 32.2, 29.6, and 55.0 pg/mL. Uveitis patients had lower plasma VEGF levels than healthy volunteers, p=0.002.Conclusions: VEGF concentration is elevated in the aqueous humor of uveitis patients with CME. Plasma VEGF concentration is reduced in uveitis patients on systemic immunosuppression. VEGF antagonists might be investigated for the treatment of uveitis-associated CME.